Navigating the AAC Roadmap: From Consideration to Implement…

But what about those misconceptions that can hinder prog- ress? We also set out to dispel these myths. One of the first roadblocks that we tend to encounter is the myth that AAC is only for nonverbal students. While AAC can be extremely beneficial for our non speaking students, it can also be very effective for supplementing the speech of those with limited verbalizations. Sometimes students can get stuck on a particular word or a scripted phrase. AAC can help these students by giving them access to more words and helping to expand their language. We know that individuals need access to hundreds of words in order to have novel communication and AAC can help bridge this gap. It can also be beneficial for stu- dents who have difficulty being understood due to articulation delays, a phonological impairment, or motor planning issues like apraxia of speech. AAC can aid in times of communication breakdowns and serve as an appropriate model of the correct production. In both of these instances, the AAC device is used as a teaching tool to increase the student’s language skills. Many parents have a fear that the use of an AAC device will prevent their child from speaking. But, the myth that AAC hinders or stops students from developing verbal communication has been completely busted! In fact, research tells us that the incor- poration of AAC in most cases actually increases verbal speech. Providing the user with increased vocabulary helps them during conversations to say longer messages. The use of AAC can also lessen the load of cognitive and/or motor demands allowing the user to free up energy for increased participation. In addition, the immediate auditory feedback that the user receives is instru- mental in providing appropriate language modeling, thus hav- ing positive effects on overall language development. The myth that seems to be the most popular, and the one that gets under my skin the most, is the misconception that there are certain prerequisite skills necessary to use AAC. Let me stand up in my chair and grab a megaphone when I say, “There are no prerequisites for using AAC!” In fact, communication is a basic human right. Too often, a student is asked to “prove” that they have the ability to use a communication system. I have actually read the statement “they aren’t ready” in a number of reports. The truth is that anyone can benefit from AAC no matter their age, motor skills, or cognitive ability. In fact, we can use AAC to teach beginning skills, and there are many access options avail- able. This is why it is so important that AAC assessment and con- sideration be a collaborative and individualized process. Once we gather information and have an understanding of the student, we can begin to trial the various tools. This brings us to the next roadblock which is the myth that AAC is one-size-fits- all. I once had a team tell me the student was using a particular app because the SLP already had it downloaded on her iPad. In another situation, a student was using a device because that was the system their division had adopted for all students. And, if you can believe it, I even had an SLP tell me that a student was using an older model high tech device (that isn’t even manufactured

anymore) because she had found it at a yard sale! Now, I cannot fault any of these teams because at least they were trying, right? But, too often we are retrofitting systems for students because it is what is convenient or what we feel comfortable with rather than looking at each user’s needs individually. The truth is that AAC systems are different in terms of the level of sophistication, the symbol system used, and the amount and organization of vocabulary. There is no one tool that is appropriate for all! When first introducing AAC, there is a dated misconception that you have to start with low tech tools. Some students can benefit from high tech from the start depending on their partic- ular needs and preferences. During the information gathering stage, the team determines the student’s current language skills. We should then match the AAC system at or slightly above this level. There is no evidence to support the myth that students have to work their way up a hierarchy of supports. In fact, this oftentimes makes the process harder for the user because we are constantly teaching them how to use a new language sys- tem. If a student understands hundreds of words then they need access to hundreds of words. I can’t tell you how many times a team has said to me, “we tried AAC but the student wasn’t in- terested in using it”. In most of these instances, it was not being used because the student didn’t find the available words useful. Imagine being nonverbal but understanding everything that is being said to you then given an AAC system that has a very limited amount of vocabulary. What is the chance that a situa- tion would arise where you would be motivated to use one of the few words that you have available? On the flip side, imagine being given a device that has hundreds of words at hand but you have a limited vocabulary. This might be very overwhelming and cause you to shut down. In both of these situations, we may see the user avoid using the device which may seem like they are not interested. Remember that we can’t always predict what others will say. Giving students access to words gives them the ability to say what they want to say when they want to say it, which is the ultimate goal of any communication system. Successful trial implementation is the result of a well devel- oped plan that ensures all team members are on the same page and working together. A good plan includes clearly stated goals, well defined roles and responsibilities and an understanding of how you will collect data. That’s right. I said it. Data is what drives our decision making and is an integral part of the pro- cess. Adopting a collection method that all team members un- derstand and making sure the data is a reflection of the goal(s) is essential. Collecting data just to collect data does nothing to help our decision making. However, when we follow the plan, meet regularly, and analyze our data as we move through the process, we can say with certainty what tools worked and what tools didn’t work. The team can then move forward with getting more long term support in place for a student with the data to back up its effectiveness.

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